Archived: The Rivendell

The Rivendell is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service Good.

At this inspection we found the service remained Good. We found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to be supported to stay safe and were protected from abuse and avoidable harm. They were supported by enough trained and knowledgeable staff who had been recruited safely. People were involved in planning their care and discussing and minimising risks. People’s medicines were managed safely. When incidents or accidents occurred people and staff worked together to minimise the risk of them happening again.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the polices and systems in place supported this practice.

People continued to be involved in the planning and reviewing of their care and support and their preferences and choices were recorded. People were supported to eat well and to remain healthy. Referrals were made to health care professionals when needed and any advice given was followed.

People had built strong, positive and trusting relationships with the staff team. Staff were kind, caring and patient and listened to and valued people’s views. Privacy and dignity was respected. People and staff laughed and chatted together and the atmosphere was relaxed.

People’s care and support plans were written with them and reflected their individual preferences and choices. People were encouraged to follow their own interests and to take part in group activities to increase their well-being. People’s religious, spiritual and cultural needs were discussed and recorded. Complaints were handled in line with the provider’s policy and people knew how to complain.

The registered manager and staff had a shared set of visons and values. There was an open, inclusive, empowering and positive culture where people lived as a family. The registered manager coached and mentored staff and worked with them each day. Regular checks and audits were carried out by the registered manager and staff from head office to ensure the service being provided was safe and effective.

The Rivendell provides accommodation and personal care for up to four people with a learning disability. The service is a small converted domestic property. Accommodation is arranged over two floors. There were four people living at the service at the time of our inspection.

A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were treated with dignity and respect at all times. Staff were kind and caring to people.

The registered manager led the staff team and had oversight of the service. Staff were motivated and felt supported by the registered manager who was approachable. The registered manager and staff shared a clear vision of the aims of the service.

There were enough staff, who knew people well, to meet their needs at all times. The needs of the people had been considered when deciding how many staff were required on each shift and to support people in different activities. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff were supported to provide good quality care and support. They had completed the training they needed to provide safe and effective care to people. Some staff held recognised qualifications in care. The registered manager met regularly with staff to discuss their role and practice.

People’s care and support was planned and reviewed to keep people safe and support them to be as independent as possible. People, their relatives and professionals who knew people well were involved in planning and reviewing their care.

Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. Plans were in place to keep people safe in an emergency. Systems were in place to manage complaints received.

People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were offered a balanced diet that met their individual needs.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary. People were not restricted and went out when they wanted to.

Systems were in place to assess if people were able to make decisions. The registered manager knew when these needed to be completed. Staff assumed they had capacity and respected the decisions they made. When people needed help or could not make a particular decision on their own, staff supported them. Decisions were made in people’s best interests with people who knew them well. The requirements of the Mental Capacity Act 2005 (MCA) had been met.

People were supported to participate in a variety of activities that they enjoyed. Possible risks to them had been identified and were managed to keep them as safe as possible, without restricting them.

The registered manager worked alongside staff and checked that the quality of the service was to the required standard. Any shortfalls found were addressed quickly to prevent them from happening again. People and their relatives were asked about their experiences of the care.

Accurate records were kept about the care and support people received and about the day to day running of the service. These provided staff with the information they needed to provide safe and consistent care to people.

Systems were in operation to regularly assess the quality of the service. People and their relatives were asked for their feedback about the quality of the service they received.

People were encouraged to remain independent and had been involved in planning their care and support with people who were important to them. People told us that staff supported them to do things for themselves and to plan their care and support. One person's relative told us, 'The manager keeps me informed about my relative. They take him to appointments and tell me the outcome'.

The service had processes in place to keep the service clean and ensure that people were protected from the risks of infection.

The service had a process in place to obtain feedback about the quality of the service people received from people using the service, their relatives and staff.

People were protected from this risk of unsafe or inappropriate care and support because their records were accurate and up to date.

People appeared to be happy and relaxed around the team. One person said 'Staff help with washing and dressing'.

We saw the home was generally clean, but that some precautions for infection control were missing. People had a wide range of nutritious meals provided. The policy and procedure for looking after people's medicines was safe and secure.

Two people said they got out and about a lot and there were enough staff to help them. A person said 'Going out later, going to see my friends'. One person said they wanted to do more skilled work, like cooking, rather than watching. Another person indicated that they would like to do more too. We saw that the care plans suggested people should get involved with staff support, but did not plan how staff should do this.

We spoke with three staff and the manager and found that they were following the care plan as written. We saw and discussed with the manager that there was a big focus on reacting to challenging behaviour, but very little on how to avoid such situations. We saw staff had a wide range of training.